Generic Template

Request for Approval under the “Generic Clearance for the Collection of
Routine Customer Feedback” (OMB Control Number: 1880-0542)
TITLE OF INFORMATION COLLECTION: ED Data Express User Experience Survey
PURPOSE: To understand use cases for Ed Data Express to introduce improved user
experiences on the new modernized site.
DESCRIPTION OF RESPONDENTS: The target for respondents is the general public who is
seeking data on education or frequent users of ED Data Express.
TYPE OF COLLECTION: (Check one)
[ ] Customer Comment Card/Complaint Form
[ ] Usability Testing (e.g., Website or Software
[ ] Focus Group

[x] Customer Satisfaction Survey
[ ] Small Discussion Group
[ ] Other: ______________________

CERTIFICATION:
I certify the following to be true:
1. The collection is voluntary.
2. The collection is low-burden for respondents and low-cost for the Federal Government.
3. The collection is non-controversial and does not raise issues of concern to other federal
agencies.
4. The results are not intended to be disseminated to the public.
5. Information gathered will not be used for the purpose of substantially informing influential
policy decisions.
6. The collection is targeted to the solicitation of opinions from respondents who have
experience with the program or may have experience with the program in the future.
Name: Katherine Kellermeyer
To assist review, please provide answers to the following question:
Personally Identifiable Information:
1. Is personally identifiable information (PII) collected? [ ] Yes [x] No
2. If Yes, is the information that will be collected included in records that are subject to the
Privacy Act of 1974? [ ] Yes [ x] No
3. If Applicable, has a System or Records Notice been published? [ ] Yes [x ] No
Gifts or Payments:
Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to
participants? [ ] Yes [x ] No
BURDEN HOURS
Category of Respondent

No. of
Participation
Respondents Time
16
10 minutes

Individuals or Households
Totals

16
respondents

10 mins

FEDERAL COST: The estimated annual cost to the Federal government is $__0___
1

Burden
3
hours
3
hours

If you are conducting a focus group, survey, or plan to employ statistical methods, please
provide answers to the following questions:
The selection of your targeted respondents
1. Do you have a customer list or something similar that defines the universe of potential
respondents and do you have a sampling plan for selecting from this universe?
[x ] Yes [ ] No
If the answer is yes, please provide a description of both below (or attach the sampling plan)? If
the answer is no, please provide a description of how you plan to identify your potential group of
respondents and how you will select them?
1. When you use the ED Data Express site, you do so as a...

□ Government Employee
□ Teacher/Administrator
□ Student
□ Parent
□ Other, please specify ____________
Administration of the Instrument
1. How will you collect the information? (Check all that apply)
[ x] Web-based or other forms of Social Media
[ ] Telephone
[ ] In-person
[ ] Mail
[ ] Other, Explain
2. Will interviewers or facilitators be used? [ ] Yes [ x ] No

Please make sure that all instruments, instructions, and scripts are submitted with the
request.

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